妊娠期糖尿病患者孕中晚期血清中SOD、MDA和GLP-1水平变化与母婴不良结局的相关性分析

Correlation Analysis between Levels of Serum SOD,MDA and GLP-1 and Adverse Outcomes of Mother and Child in Patients with GDM in the Second and Third Trimester of Pregnancy

目的探讨妊娠期糖尿病患者孕中晚期血清中超氧化物歧化酶(SOD)、丙二醛(MDA)和胰高血糖素样肽1(GLP-1)水平变化与母婴不良结局的相关性。方法选取2016年1月至2017年1月南充市中心医院收治的125例妊娠期糖尿病孕中晚期患者(病例组)和同期在我院体检的30名健康孕妇(健康组)为对象,比较两组血清中SOD、MDA和GLP-1水平以及母婴不良结局情况,并对SOD、MDA、GLP-1水平与母婴不良结局进行多因素分析。结果与健康组比较,病例组SOD、GLP-1水平明显低,MDA水平明显高,差异有统计学意义(P<0.001);病例组巨大儿、新生儿低血糖、剖宫产发生率及不良妊娠结局总发生率明显高于健康组(P<0.05);不良组糖化血红蛋白、MDA较无不良组明显高,SOD、GLP-1较无不良组明显低,差异有统计学意义(P<0.001);MDA升高、SOD降低、GLP-1降低和妊娠期合并糖尿病是孕中晚期不良母婴结局的危险因素。结论妊娠期糖尿病孕中晚期患者机体存在明显氧化应激反应及GLP-1抵抗现象,血清SOD、MDA、GLP-1水平与巨大儿、新生儿低血糖及剖宫产的不良妊娠结局有明显相关性。

Objectives To investigate the correlation between the levels of serum superoxide dismutase （SOD）, malondialdehyde （MDA） and glucagon like peptide 1 （GLP-1） and the adverse outcomes of mother and child in patients with gestational diabetes mellitus （GDM） in the second and third trimester of pregnancy. Methods A totol of 125 pregnant women with GDM in the second and third trimester of pregnancy treated in Nanchong Central Hospital from January 2016 to January 2017 were enrolled into the case group, and the other 30 to the healthy pregnant women undergoing the physical examination over the corresponding period were selected into the control group. The levels of serum SOD, MDA and GLP 1 and the adverse outcomes of mother and child were compared between the two groups, and the multivariate analysis was used to analyze the levels of SOD, MDA and GLP-1 and the adverse outcomes of mother and child. Results Compared with the control group, the levels of serum SOD and GLP-1 were significantly lower and the level of MDA was significantly higher in the case group （P〈0. 001）. The incidences of fetal macrosomia, neonatal hypoglycemia, cesarean section and adverse pregnancy outcomes in the case group were significantly higher than those in the control group （P〈0.05）. The levels of glycosylated hemoglobin and MDA were significantly higher and the levels of GLP-1 and SOD were significantly lower in the adverse group than in the non adverse group （P〈0. 001）. The increase of MDA, decreases of SOD and GLP-1 and GDM were independent risk factors for the adverse outcomes of mother and child in patients with GDM in the second and third trimester of pregnancy. Conclusion There is obvious oxidative stress reaction and GLP-1 resistance in patients with GDM in the second and third trimester of pregnancy. The levels of serum SOD, MDA and GLP-1 are significantly correlated with adverse pregnancy outcomes such as fetal macrosomia, neonatal hypoglycemia and cesarean section.